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Do You Ever Feel Bad After Having Sex that Was Good?

A new study about the mysterious condition called Postcoital Dysphoria

After having sex that’s satisfying, both partners will usually bask in the afterglow and often feel good emotionally. But some people occasionally feel bad after having sex that was good, and not simply because they’ve been sheltering in place with their partner for what seems like an eternity.

When people feel unhappy or bad after having sex that was satisfactory and consensual, it’s called postcoital dysphoria. Unfortunately, the term postcoital means after intercourse, while these bad feelings can occur after masturbation, oral sex, dry humping or finger play and not just intercourse or sex with a partner.

Until recently, it’s been assumed that approximately 2% of women and 3% to 4% of men experience postcoital dysphoria on a regular basis, and half of all people have experienced it at least once during their lifetime. But according to a recent study published in the Journal of Sexual Medicine, postcoital dysphoria is way more common than was previously thought and it has a greater range of symptoms.

More than 90% of the people in this study said they experienced sadness, unhappiness, frustration, agitation, mood swings, flu-like symptoms, or low energy at least once during the past four weeks after they had masturbated or had sex with a partner that was satisfactory. There were some differences between the men’s and women’s symptoms, but they did not reach statistical significance.

Unfortunately, the authors didn’t define what they meant by “satisfactory sex,” so it's not clear whether it means sex that was satisfying or simply sex that you didn’t hate. They did specify that it was sex that was consensual.

While I applaud the authors of this study for researching such an important and under-studied subject, I was disappointed at how poorly the study was presented. When I was on the editorial board of the Journal of Sexual Medicine, I would never have green-lighted this study for publication without requiring serious changes. If I were teaching a graduate course on research and study design, this study would be on my examples of what you shouldn’t do. Still, there’s a lot we can learn from it.

Are the Findings Right or Wrong?

Do my concerns about this study mean the findings are wrong? I can’t tell you, because the way the authors arrived at them is confusing. Fortunately, we can learn almost as much from studies with flaws as from studies that hit it out of the park. Even the most respected studies in human behavior often have more weaknesses than strengths. This doesn’t mean we should ignore or dismiss them but that we need to be careful about generalizing the results of any study beyond the individuals who were actually studied.

The Internet Must Have Been Down

Internet convenience studies (AKA, online studies) are known for their large number of respondents. This is perhaps their greatest strength. Yet even after posting ads at different hospitals, universities and on social platforms such as Facebook, only 223 women and 76 men ended up completing the entire questionnaire for this study.

What particularly concerns me is the average male in this study was almost 43 years old, or more than 8 years older than the average female, and 21.1% of the men who filled out the questionnaires “suffered from a clinically diagnosed (but-self reported) depression.” What? According to the National Institute of Mental Health, about 5.3% of males suffer from major depression, so it seems a big chunk of the few men who completed this online study were unhappy dudes. More importantly--why, if you could only find 76 men on the entire Internet to complete your study, would you even include males?

Low Energy and Lethargy after Sex and Masturbation?

Since the beginning of time, humans have used masturbation as a way to help speed up the transition from wakefulness to sleep. So I don’t understand why this study would say that feelings of lethargy or low energy after masturbation are symptoms as opposed to a goal.

Also, what if a man has worked hard to please a partner during partner sex? Perhaps that’s not tiring to men in Switzerland and Germany where the study was done, but it can be for men in the United States.

It could be the problem is one of translation from German or Swiss into English. Maybe ”low energy” is not what the authors meant. (I emailed the lead author with questions about this, but did not receive a reply.) Unfortunately, when a study is only a couple of pages long and doesn’t include the actual questions that were asked, it tends to leave readers scratching their heads.

Flu-Like Symptoms After Sex?

Unless you were being groped while on the Nitro rollercoaster at Six Flags or the Steel Vengeance at Cedar Point, or you were having sex on the top bunk in a dorm room, I’m not sure why someone would have “flu-like” symptoms after sex. But according to this study, 52.5% of men and women experienced “flu-like” symptoms following sex during the past four weeks. A more detailed explanation of what the authors meant by “flu-like” symptoms would have been helpful.

Questions About Their Questions

One of the most important parts of any study has to do with the questions that were asked and whether they measured what the study says they did. The authors of this study created their own questionnaire “based on previous literature descriptions... and further influenced by face-to-face discussion among three sexual medicine experts.” Giventhat they were not using a validated questionnaire, the authors should have at least included the questions and questionnaire they developed. But no such luck. To their credit, the authors did mention this in their brief “study limitations” section. But I’m not sure how including a quick “our bad” at the end of a study makes it any better.

My Conclusion about Their Conclusion

This is a flawed study with some very interesting and fascinating results: 91.9% of the participants reported having had “postcoital symptoms” over the past four weeks, with the most common symptoms being mood swings, sadness, unhappiness and low energy. Other symptoms included frustration, flu-like symptoms, and worthlessness.

I realize that the goal of the authors was to broaden understanding of postcoital dysphoria or postcoital symptoms, but to me, the important takeaway is, if you occasionally experience symptoms like these after having had sex that was satisfactory or after masturbating, then you are by no means alone. But if you have such symptoms often following sex, you should consider discussing them with a therapist, depending on the severity of the symptoms and whether they are affecting your enjoyment of sex.

References

Burri A, Hilpert P. Postcoital Symptoms in a Convenience Sample of Men and Women. J Sex Med 2020;17:556e559.

National Institute of Mental Health statistics on Depression.

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